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UNITED STATES BANKRUPTCY COURT
FOR THE DISTRICT OF KANSAS
IN RE: LOTS A'BAGELS
CASE NO. 00-11443
DEBTOR(S) CHAPTER 11
MONTHLY REPORT
FOR MONTH OF AUGUST, 2000
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CASE NAME: LOTS A' BAGELS
CASE NO. 00-11443
CHAPTER 11
MONTHLY REPORTING AFFIDAVIT
FOR THE MONTH ENDING AUGUST 23, 2000
1 PROVIDE THE FOLLOWING INFORMATION REGARDING SALARIES/WAGES
PAID/DUE.
GROSS AMOUNT OF EXECUTIVE SALARIES PAID -
NAME TITLE
GROSS AMOUNT OF OTHER WAGES PAID 36,322.73
WERE ANY WAGES/ SALARIES DUE BUT NOT PAID FOR THIS CURRRENT
MONTH? YES NO X . IF YES, PROVIDE THE EMPLOYEE'S NAME
AND TITLE AND AMOUNT DUE.
2 PROVIDE THE FOLLOWING INFORMATION REGARDING TAXES PAID/DUE.
ARE ALL POST-PETITION FEDERAL AND STATE TAXES PAID OR DEPOSITED
FOR THE PERIOD? YES NO X
PROVIDE DOLLAR DETAIL OF TAXES FOR THIS PERIOD.
AMOUNT DUE TAXES PAID
TYPE OF TAX FOR MONTH DURING MONTH
CK # DATE AMOUNT
FEDERAL WITHHOLDING
FICE WITHHOLDING ACH TRANSFER 08/09/2000 8,362.01
EMPLOYER'S FICA
STATE WITHHOLDING CK #11310 08/15/2000 2,334.00
SALES TAX CKS 5040+5041+5042+ 08/09/2000 8,433.00
5043
OTHER TAXES
ATTACH PHOTOCOPIES OF IRS FORM 6123 AND SIMILAR RECEIPT FROM THE STATE
TAXING AUTHORITY TO VERIFY THE DEPOSITS OR PAYMENTS
PAGE 1 OF 3
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CASE NAME: LOTS A' BAGELS
CASE NO. 00-11443
CHAPTER 11
MONTHLY REPORTING AFFIDAVIT
FOR THE MONTH ENDING AUGUST 23, 2000
3 DOES ALL INSURANCE COVERAGE REMAIN IN EFFECT? YES X NO
TYPE CARRIER POLICY # EXP DATE
PROPERTY DAMAGE TRAVELERS BINDER 105412 AUGUST 2000
LIABILITY TRAVELERS BINDER 105412 AUGUST 2000
WORKERS COMP PREFERRED EMPLYRS BINDER 105382 AUGUST 2000
PREFERRED EMPLYRS BINDER 105402 AUGUST 2000
OTHER
AUTOMOBILE TRAVELERS BINDER 105423 AUGUST 2000
PROPERTY/LIABILITY TRAVELERS BINDER 105422 AUGUST 2000
4 DO ALL REQUIRED LICENSES REMAIN IN EFFECT? YES X NO
DESCRIPTION RENEWAL DATE
FOOD/HEALTH VARIES BY STORE
5 LIST DEBTS INCURRED WHICH HAVE NOT BEEN PAID.
(I.E. UTLITY BILLS, REPAIR BILLS, PROFESSIONAL FEES)
DATE INCURRED CREDITOR PURPOSE AMOUNT
VARIOUS VARIOUS PRE-PET 187,614.21
SCHEDULE 5A POST-PET 25,926.78
TOTAL 213,540.99
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CASE NAME: LOTS A' BAGELS
CASE NO. 00-11443
CHAPTER 11
MONTHLY REPORTING AFFIDAVIT
FOR THE MONTH ENDING AUGUST 23, 2000
6 CHECK [ X] THAT THE FOLLOWING FORMS ARE ATTACHED:
RECEIPTS AND DISBURSEMENTS STATEMENT X
INCOME STATEMENT X
BALANCE SHEET (QUARTERLY ONLY) X
COPY OF BANK STATEMENT (S) X
FORM 6123
COPY OF CHAPTER 11 QUARTERLY FEE
PAYMENT REPORT (INCLUDE FOR MONTH
DURING WHICH FEE IS PAID)
I (WE) DECLARE UNDER PENALTY OF PERJURY THAT THIS REPORT AND ATTACHED
STATEMENTS ARE TRUE AND CORRECT TO THE BEST OF MY (OUR) KNOWLEDGE AND
BELIEF.
DATED: SEPTEMBER 14, 2000 DEBTOR: *
CO-DEBTOR: **
* THIS REPORT MUST BE SIGNED BY AN INDIVIDUAL HAVING SUFFICIENT KNOWLEDGE
OF THE FACTS TO MAKE A TRUTHFUL AND FULL STATEMENT.
** IF THIS IS A JOINT PETITION, BOTH HUSBAND AND WIFE MUST SIGN.
NOTE: THIS REPORT AND ATTACHED STATEMENTS ARE DUE FOR EACH
CALENDAR MONTH PERIOD FROM TIME OF FILING PETITION (FIRST
REPORT WILL BE FOR A SHORT PERIOD) UNTIL THE CASE IS DISMISSED,
CONVERTED OR A PLAN IS CONFIRMED. THE REPORT IS DUE THE 15TH
OF THE MONTH FOLLOWING THE REPORTING PERIOD. (IE. JANUARY
REPORT IS DUE FEBRUARY 15TH)
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